Cisplatin has been widely used as chemotherapeutic agent for the treatment of cervical cancer, ovarian cancer, head and neck cancer and squamous cell carcinoma of lung. But cisplatin is highly toxic with nephrotoxicity, gastrointestinal toxicity, myelosuppression and neurotoxicity. The second generation drug of platinum compound, carboplatin was developed in 1980s to reduce side effects. Carboplatin has low nephrotoxicity but its major toxic effect is thrombocytopenia, In this study, the side effects of cisplatin and carboplatin were evaluated on 37 patients of cervical cancer in 169 chemotherpy cycles who were recieved combined VBP chemotherpeutic regimen consisting of cisplatin or carboplatin. Nephrotoxicity of grade 2 or over were 16% in cisplatin group and 1% in carboplatin group. Granulocytopenia of grade 2 or over were 34% in cisplatin group and 10% in carboplatin group. Thrombocytopenia of grade 2 or over were 7% in cisplatin group and 21% in carboplatin group. Gastrointestinal toxicity of grade 2 or over were 11% in cisplatin group and 0% in carboplatin group. This clinical study demonstrated that cisplatin has more toxic effects than carboplatin except thrombocytopenia.
Agranulocytosis ; Carboplatin* ; Carcinoma, Squamous Cell ; Cisplatin* ; Drug Therapy, Combination* ; Head and Neck Neoplasms ; Humans ; Lung ; Ovarian Neoplasms ; Platinum ; Thrombocytopenia ; Uterine Cervical Neoplasms

No abstract available.

BACKGROUND: Although the poor short-term outcome of antiepileptic drug (AED) treatment may represent long-term AED refractoriness in general, the same hypothesis in temporal lobe epilepsy (TLE) has yet to come up as an important subject to be investigated. We examined to decide early drug intractability and aid treatment plan. METHODS: From a prospective patient cohort of Yonsei Epilepsy Clinic, 121 newly-referred TLE patients were selected to participate in this study. First, we divided the patients into two groups according to their second one-year remission at two year of AED treatment. One group was the remission group (RG) and the other was the non-remission group (NRG). Second, we evaluated clinical characteristics influencing remission between the two groups. RESULTS: Nineteen patients (15.7%) were RG whereas 102 (84.3%) were NRG. The six month remission and terminal remission at the first year of AED treatment and the first one year remission rate in patients with RG was significantly higher than those with NRG (P<0.05). In patients with NRG, the number of complex partial seizures and secondary generalized seizures, the annual frequency of secondary generalized seizures prior to AED treatment, polypharmacy, new drug use, and drug side effects were significantly higher (p<0.05) than RG. CONCLUSIONS: The earlier seizure outcome may influence the later prognosis of AED treatment in non-lesional TLE. The prognosis during the second year of AED treatment is influenced by drug treatment and the number of generalized seizures.
Anticonvulsants ; Cohort Studies ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Polypharmacy ; Prognosis* ; Prospective Studies ; Seizures ; Temporal Lobe*

In Korea, there are about 8 million motor vehicles and one-fourth of it is motorcycle. Last year Korean government report on the motor vehicle accidents claimed 12,781 cases of motorcycle accidents and it account for 5.1% of all of motor vehicle accidents occurred in Korea. But this is too broad analysis and lack of statical values. In general, most of people think motorcycle rider will suffer or die from head injuries sustained with motorcycle accident. Even though mandatory law on wearing helmet during motorcycle ride, but we see too many motorcycle riders not wearing helmet, especially in teenagers. The loss of young person by accident is great loss for family, society and economy of nation. No one will doubt the effectiveness of helmet on reduced incidence of head injuries. And multiple studies from United States of America have clearly demonstrated the benefit of helmets in motorcycle accidents. The following study was undertaken to determine the relationship between head injuries and helmet use in motorcycle accident, as well as analysis of general motorcycle accident.
Adolescent ; Americas ; Craniocerebral Trauma ; Head Protective Devices ; Humans ; Incidence ; Jurisprudence ; Korea ; Motor Vehicles ; Motorcycles* ; United States

No abstract available.
Humans

Nursing science is focusing increasingly on family health care. Especially during the launching stage of family the grown-up sons daughters, and middlescent parents daughters have experienced a lot of change. The purpose of this study is to investigate the family health during the launching stage of the family by utilizing the family health assessment tool based on Roy's adaptation model. The Roy adaptation model was used as it is the best practice-based framework for Family Health Nursing Care. The data was collected using a structured questionnaire. The structure of the questionnaire was developed from the Family Health Assessment Tool by S.O. Jang(1996). The sample of 276 subjects was a convenient sample and data was obtained from November 14, 1996 to December 4, 1996. In order to analyze the collected data, this study utilized frequency, percentile, average, ANOVA, Cronbach's, and factor analysis. The results from this research are summarized as follows : 1. The degree of family health is average 95.24+/-9.40 ranged in middle. 2. The significant difference between general characteristics and family health was only revealed with the major decision making person in the family. This research thus suggests the following : 1. The legal system is needed in order to check the family members' health state regularly. 2. With family nursing care, it has to identify who is the major decision maker in that family. 3. There is a need to redefine the family health assessment tool. 4. Further research will attempt to investigate family health in each family's developmental stage.
Decision Making ; Family Health* ; Family Nursing ; Humans ; Nuclear Family ; Nursing ; Nursing Care ; Parents ; Surveys and Questionnaires

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Propafenone is a new class Ic antiarrhythmic compound.This study was performed to evaluate the clinical efficacy and safety of propafenone by double-blind, placebo-controlled, randomized cross-over comparison of propafenone and disopyramide in patients with stable ventricular ectopy. METHODS: All patients were included in the study if they had an average of at least 30 PVC/hr on a 24-hour Holter recordings. During the 1st 7 days, two placebo tablets(identical in apperance to the propafenone and the disopyramide tablets) were administrated in a double-blind manner(run-in period). Then 1st treatment period lasting 1 week with one verum and the other placebo, wish-out period of 3 day,2nd treatment period lasting 1 week with cross-over drugs were followed. RESULTS: Twenty patients were enrolled. During the run-in period, VPCs were reduced to 18%, compared to the baseline data before the administration of placebo.During the treatment period,propafenone 600mg/day reduced VPCs by 43% and disopyramide 400mg/day reduced VPCs by -10% Propafenone was effective(80% or greater reduction of VPCs) in 7 of 20 patients. Disopyramide was not effective in all patients. Propafenone and disopyramide produced no significant change of paired VPCs and VT events. Propafenone had no effect on heart rate. It increased the PR interval(7.9%;p<0.01) and QRS interval(5.2%;p<0.01). The drug did not change QTc interval(-1.1%) significantly. There were no cardiovascular side effects. Propafenone produced nausea in one patient. Disopyramide produced dysuria in 2 patients. CONCLUSIONS: Propafenone was more effective in controlling VPC than disopyramide, and there was no major limiting side effects.
Cross-Over Studies* ; Disopyramide* ; Dysuria ; Heart Rate ; Humans ; Nausea ; Propafenone* ; Ventricular Premature Complexes*

Although microscopic analysis of tissue slides has been the basis for disease diagnosis for decades, intra- and inter-observer variabilities remain issues to be resolved. The recent introduction of digital scanners has allowed for using deep learning in the analysis of tissue images because many whole slide images (WSIs) are accessible to researchers. In the present study, we investigated the possibility of a deep learning-based, fully automated, computer-aided diagnosis system with WSIs from a stomach adenocarcinoma dataset. Three different convolutional neural network architectures were tested to determine the better architecture for tissue classifier. Each network was trained to classify small tissue patches into normal or tumor. Based on the patch-level classification, tumor probability heatmaps can be overlaid on tissue images. We observed three different tissue patterns, including clear normal, clear tumor and ambiguous cases. We suggest that longer inspection time can be assigned to ambiguous cases compared to clear normal cases, increasing the accuracy and efficiency of histopathologic diagnosis by pre-evaluating the status of the WSIs. When the classifier was tested with completely different WSI dataset, the performance was not optimal because of the different tissue preparation quality. By including a small amount of data from the new dataset for training, the performance for the new dataset was much enhanced. These results indicated that WSI dataset should include tissues prepared from many different preparation conditions to construct a generalized tissue classifier. Thus, multi-national/multi-center dataset should be built for the application of deep learning in the real world medical practice.
Adenocarcinoma ; Classification ; Dataset ; Diagnosis ; Learning ; Observer Variation ; Stomach